Wagener P
Rheumazentrum Hannover.
Z Rheumatol. 1994 Nov-Dec;53(6):346-50.
The significance of acral nodulosis under methotrexate therapy is still controversial. Among patients with rheumatoid arthritis and methotrexate therapy this manifestation could be observed in 8/163 (5%). All cases were seropositive and already treated with other LAAD. Patients with other inflammatory rheumatic diseases under methotrexate therapy (n = 83) did not develop this nodulosis. The acral nodulosis is interpreted as a typical side-effect of methotrexate only in patients with rheumatoid arthritis. Histopathologically, these nodules do not differ from the typical rheumatoid nodule.
甲氨蝶呤治疗下出现肢端结节病的意义仍存在争议。在类风湿关节炎接受甲氨蝶呤治疗的患者中，163例中有8例（5%）出现了这种表现。所有病例均为血清阳性，且已接受其他慢作用抗风湿药治疗。接受甲氨蝶呤治疗的其他炎性风湿性疾病患者（n = 83）未出现这种结节病。肢端结节病仅在类风湿关节炎患者中被视为甲氨蝶呤的典型副作用。组织病理学上，这些结节与典型的类风湿结节并无差异。
